Marywood Convalescent Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2674 Issued in WI

Legal business name

MARYWOOD CONVALESCENT CENTER

Doing business as

Catholic Residential Services, Inc.

Practice address

1821 N 4TH Ave
Wausau, WI 54401-1910

Phone

(715) 675-9451

Fax

(715) 675-4051

NPI assigned

May 31, 2005

Organization subpart

Yes

Parent organization

CATHOLIC RESIDENTIAL SERVICES, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kevin J Rymanowski

Title

SVP Finance

Phone

(763) 689-1162

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Catholic Residential Services, Inc. Doing business as

Part of

Riverdale Marriage Fa

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481068800000",
    "number": "1922001247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 E RUM RIVER DR S",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550082656",
            "telephone_number": "763-689-1162",
            "fax_number": "763-689-6117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 N 4TH AVE",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544011910",
            "telephone_number": "715-675-9451",
            "fax_number": "715-675-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYWOOD CONVALESCENT CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CATHOLIC RESIDENTIAL SERVICES, INC.",
        "enumeration_date": "2005-05-31",
        "last_updated": "2016-12-07",
        "status": "A",
        "authorized_official_last_name": "RYMANOWSKI",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SVP FINANCE",
        "authorized_official_telephone_number": "763-689-1162"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "2674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20109300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Catholic Residential Services, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marshfield Clinic (Wausau Eye Center)
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• Marshfield Clinic Inc
• Charles K Martin, PA
• Stacey Martin
• William R. Mason, D.O.
• Dorothy R Mathews, RN
• David L Mathias, M.D.
• Jeff Mathias, CRNA
• Katrina Marie Mattek, PA-C

• Skilled Nursing Facility in Wausau, WI
• Providers in Wausau, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.